Risk of Dependency: A Challenge for Health and Social Care Planning-Observational Stroke Cohort.

BACKGROUND: After a stroke, families require the coordinated assistance of health and social care. Currently there is a lack of comprehensive evaluation and assessment tools to identify discharge needs, and there is separate management of health and social resources, and access to these services is variable between regions. OBJECTIVE: The main objective of this study was to assess the factors associated with risk of dependency after stroke and propose a suitable instrument for identifying patients at higher risk. METHODS: This was a 2-year prospective and community study of a stroke cohort. The primary outcome was recognized dependency. The potential predictors were considered in a multivariate regression and area under curve (AUC) to evaluate its discriminative capacity. RESULTS: Overall, 233 stroke survivors were recruited, 49.8% of whom were women, and the average age was 78.1 ± 11.6 years. The total rate of dependency was 31.5 (95% confidence interval [CI] 26.1-37.7) cases/100 person-years. The independent factors associated with dependency outcome were age >80 years (hazard ratio [HR] 2.03, 95% CI 1.32-3.12, P = .001), Pfeiffer score ≥4 (HR 1.82, 95% CI 1.25-1.2.66, P = .002), Barthel score <60 (HR 1.79, 95% CI 1.21-2.66, P = .003), and Charlson score ≥3 (HR 1.49, 95% CI 1.02-2.16, P = .039). The AUC was 0.84 (95% CI 0.79-0.89; P < .001). CONCLUSIONS: Stroke has serious effects on the dependency outcomes. The patient's age, cognitive or physical impairment, and comorbidities as measured on the Pfeiffer score, Barthel Index, and Charlson score identified people at high risk and may ease the integrated role of social and health services.

[Do the Spanish university students follow Mediterranean dietary patterns?]. / ¿Siguen patrones de dieta Mediterránea los universitarios Españoles?

OBJECTIVE: To determine the pattern of food intake among the students of the University of Alicante (UA) by the level of adherence to the Mediterranean diet. METHODS: Descriptive trans-sectional study estimating the individual intake by means of a questionnaire of food intake frequency (QFIF) in a representative sample of 380 college students. STUDY VARIABLES: age, gender, geographical area of origin, self-communicated weight and height; types and intake frequencies of the foods included in the QFIF. The percentage of adherence was calculated taking into account the actual intake and the intake recommended in the guideline of traditional Mediterranean diet: 100 x servings consumed/recommended servings. We established 5 ranges of percentage of adherence: optimal intake (80%-119%), acceptable intake (60%-79%), deficient intake (40%-59%), very deficient intake (< 39%), excessive intake (> 120%). We analyzed the differences in proportions distribution and the Student's t test with EPIDAT 3.1 and SPSS 15.0. RESULTS: The prevalence of overweight/obesity is higher in men (34.6%) than in women (9.8%), p < 0.001, whereas women had higher prevalence of low weight (7.0%) than men (0.7%), p < 0.05. The consumption of grains and derivatives was very deficient (women = 90.6; men = 94.9) whereas the intake of red meats (women = 90.6; men = 92.7) and cold meats (women = 95.9%, men = 96.3%) was excessive. No student had an "optimal intake" or an "acceptable intake" of all the dietary groups (n = 12). DISCUSSION: The educational level and access to the information do not protect the university population from socio-environmental factors that have an influence on their dietary habits. The public health strategies focused on this population group should be strengthen.